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It's his day off, but that doesn't stop Mark from showing up at work. He gets a patient with heart problems who dies and an insecure Mark thinks it might be his fault. Later on, Morgenstern and a lawyer want to talk to Mark about the O'Brien case of the year before. Harper finds a patient for Vucelich's study and tells Carter but he omits to tell Vucelich and Benton it was Harper who found the patient instead of him. After Vucelich tells Benton the patient wasn't suited for the study, Benton starts to doubt Vucelich's study. Carol takes care of a lady who has with her a bucket of worms while Doug has a kid who's medically fine, but does have some other problems that need to be talked about.

"It's not easy being green", the phrase which this episode's title derives from, is actually a sing written by Joe Raposo and was originally performed by Kermit the Frog for Sesame Street (1969). The phrase appears in pop culture as an expression of melancholy.